A Case of Swyer-James' Syndrome Diagnosed at Age 70

• Published in: Nihon Kyōbu Shikkan Gakkai zasshi Vol. 28; no. 7; pp. 994 - 998
• Main Authors: Sakai, Masao, Kiguchi, Toshio, Suzuki, Shinya, Hitomi, Hideaki, Sugiyama, Keisaku, Takeda, Jun, Kudoh, Kazuhiko, Matsuoka, Takeshi, Takatani, Osamu
• Format: Journal Article
• Language: English; Japanese
• Published: Japan The Japanese Respiratory Society 01.07.1990
• Subjects: Aged; Humans; Lung - diagnostic imaging; MacLeod' syndrome; Male; Pulmonary Artery - abnormalities; Pulmonary Emphysema - diagnosis; Pulmonary Emphysema - diagnostic imaging; Radiography; Swyer-James' syndrome; Syndrome; Unilateral hyperlucent lung
• DOI: 10.11389/jjrs1963.28.994
• ISSN: 0301-1542

A male case of Swyer-James' syndrome, who had been followed for bronchiectasis for a long time, detected at age 70 and diagnosed by radiological studies was reported. The movement of his left diaphragm was impaired. Arterial oxygen tension was 68 torr while breathing room air. Pulmonary function tests showed mixed ventilatory impairment, inrease of residual volume, and uneven gas distribution, but diffusing capaity was normal with the single breath method. Chest radiograph revealed hyperlucency of the left lung and the right middle lung field. In these areas, pulmonary angiography showed marked hypovascularity and diffuse vascular atrophy, and perfusion and inhalation scans also showd marked decreased perfusion and ventilation. Pulmonary hypertension was not detected by right heart catheterization. Fiberoptic bronchoscopy was performed and showed no abnormality of the left bronchial tree, and bronchography demonstrated diffuse cylindrical bronchiectasis of the left lung with no alveolar filling. He had suffered from chronic sinositis for a long time, which might suggest that he had sinobronchitis due to congenital abnomality of the airway and this caused continuous respiratoey infection, which could cause this syndrome. Including our own case, about 80 cases of Swyer-James' syndrome have been reported in Japan. But only 4 cases were above 70 years of age and all of them were male, and there has been no female cases above age 50. Males prdominate over femals, and in both sexes the left lung was more commonly affcted than the right.